CAJ | 학술논문

目的：探讨表观扩散系数（ADC）值及相对表观扩散系数（rADC）值在评价缺血性脑梗死缺血半暗带中的应用价值。方法：对42例超急性期脑梗死患者行常规 CT、MRI、DSA 检查，并于24 h 后行 CT 及 MRI 复查，根据患者出现临床症状到 MRI 检查时间分为超急性期（发病6 h 以内）、急性期（6～24 h）和亚急性早期（24 h～7 d）。对比分析不同时期患侧梗死核心区、缺血半暗带与健侧镜像区的 ADC 及 rADC 值。结果：超急性期、急性期及亚急性期梗死核心区 ADC 值及 rADC 值均低于健侧镜像区，缺血半暗带 ADC 值及 rADC 值仅轻度下降，平均降幅为20％。梗死核心区与缺血半暗带ADC 值及 rADC 值随着发病时间延长，上升趋势不同。缺血半暗带 ADC 值及 rADC 值均高于梗死核心区，差异有统计学意义（P ＜0．01）。结论：ADC 值及 rADC 值对判定缺血半暗带具有较高的临床应用价值，有望成为一种简便易行的确定缺血半暗带的检查方法，为指导患者进行临床治疗提供重要的影像学依据。
목적：탐토표관확산계수（ADC）치급상대표관확산계수（rADC）치재평개결혈성뇌경사결혈반암대중적응용개치。방법：대42례초급성기뇌경사환자행상규 CT、MRI、DSA 검사，병우24 h 후행 CT 급 MRI 복사，근거환자출현림상증상도 MRI 검사시간분위초급성기（발병6 h 이내）、급성기（6～24 h）화아급성조기（24 h～7 d）。대비분석불동시기환측경사핵심구、결혈반암대여건측경상구적 ADC 급 rADC 치。결과：초급성기、급성기급아급성기경사핵심구 ADC 치급 rADC 치균저우건측경상구，결혈반암대 ADC 치급 rADC 치부경도하강，평균강폭위20％。경사핵심구여결혈반암대ADC 치급 rADC 치수착발병시간연장，상승추세불동。결혈반암대 ADC 치급 rADC 치균고우경사핵심구，차이유통계학의의（P ＜0．01）。결론：ADC 치급 rADC 치대판정결혈반암대구유교고적림상응용개치，유망성위일충간편역행적학정결혈반암대적검사방법，위지도환자진행림상치료제공중요적영상학의거。
Objective:To investigate the clinical application of using apparent diffusion coefficient (ADC)value and relative ADC (rADC)value in the evaluation of ischemic penumbra in cerebral infarction.Methods:42 cases of hyperacute cerebral infarction underwent conventional CT and MRI scanning,as well as DSA examination,24h follow-up study of CT and MRI were also performed.According to the onset of clinical symptoms and the timepoint of MR examination,hyper-acute phase (within 6h after onset of clinical symptoms),acute phase (6~24h)and subacute phase (24~7d)were defined. The ADC value and rADC value of the core of infarction,penumbra and the mirror areas in contralateral were measured and analyzed;comparison between the affected side and contralateral were performed.Results:The ADC and rADC values of the core of infarction were lower than that of contralateral mirror area in hyperacute,acute and subacute phase.The ADC and rADC values were only slightly decreased in penumbra,with an average decline as 20%.The ADC and rADC values of the infarction core and ischemic penumbra ascended differently as the prolongation of the onset time.The ADC and rADC values in ischemic penumbra were higher than those in infarction core with statistically significant differences (P <0.01).Conclu-sion:The ADC and rADC values had a high clinical application value in the diagnosis of ischemic penumbra,which could be used as a simple and easy way to detect the ischemic penumbra,providing an important imaging evidence for clinical manage-ment.